摘要
[目的]探讨中医临床决策系统在治疗中重度宫腔粘连(intrauterine adhesion,IUA)中的应用及效果。[方法]采用随机对照试验进行前瞻性研究,选择2022年1月至12月在杭州市某三级甲等中医院行宫腔镜下子宫粘连松解术的中重度IUA患者,根据是否通过中医优势病种临床决策系统进行辨证论治分为对照组(51例)、决策系统组(53例)、临床医师组(54例),比较3组患者治疗前后月经量改善、美国生育协会(American Fertility Society,AFS)评分、子宫内膜厚度、子宫内膜血流参数、中医伴随症候疗效。[结果]治疗后3组患者月经量比较,决策系统组、临床医师组较对照组均有显著改善,差异有统计学意义(P<0.05),决策系统组与临床医师组差异无统计学意义(P>0.05)。治疗后3组患者宫腔AFS评分比较,决策系统组、临床医师组较对照组显著下降(P<0.01),决策系统组与临床医师组差异无统计学意义(P>0.05)。治疗后3组患者子宫内膜厚度显著增加,子宫内膜血流参数显著下降,差异有统计学意义(P<0.01),但治疗前后组间差异均无统计学意义(P>0.05)。治疗后3组患者中医伴随症候疗效比较,临床医师组较对照组、决策系统组明显改善,差异有统计学意义(P<0.05),对照组与决策系统组差异无统计学意义(P>0.05)。[结论]中医临床决策系统用于中重度IUA的治疗可显著改善患者月经量,降低术后AFS评分,防止粘连再发生。
[Objective]To explore the application and effect of traditional Chinese medicine(TCM)clinical decision-making system in the treatment of moderate or severe intrauterine adhesion(IUA).[Methods]A prospective randomized controlled trial was conducted.Patients with moderate or severe IUA who underwent hysteroscopic uterine adhesiolysis in a tertiary hospital of TCM in Hangzhou from January 2022 to December 2022 were selected.The patients were divided into control group(51 cases),decision system group(53 cases)and clinician group(54 cases)according to whether they were treated by TCM dominant disease clinical decision-making system.The improvement of menstrual volume,American Fertility Society(AFS)score,endometrial thickness,endometrial blood flow parameters and the efficacy of TCM accompanying symptoms were compared among the three groups before and after treatment.[Results]Compared with control group,the menstrual volume of decision system group and clinician group were significantly improved(P<0.05),but there was no significant difference between decision system group and clinician group(P>0.05).Compared with control group,the AFS scores of uterine cavity in decision system group and clinician group were significantly decreased(P<0.01),and there was no significant difference between decision system group and clinician group(P>0.05).The endometrial thickness was significantly increased and the endometrial blood flow parameters were significantly decreased in the three groups after treatment,and the differences were statistically significant(P<0.01),but there was no significant difference among the three groups before and after treatment(P>0.05).Compared with control group and decision system group,the clinical physician group had significantly improved efficacy of TCM accompanying symptoms(P<0.05),and there was no significant difference between control group and decision system group(P>0.05).[Conclusion]TCM clinical decision system for IUA can significantly improve the menstrual volume of patients with moderate or severe IUA,reduce postoperative AFS score and prevent the recurrence of adhesion.
作者
沈毅
马景
李瑾
周彧
戴世访
SHEN Yi;MA Jing;LI Jin(Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University,Hangzhou 310007,China)
出处
《浙江中医药大学学报》
CAS
2024年第3期300-306,共7页
Journal of Zhejiang Chinese Medical University
基金
浙江省中医药科技计划项目(2022ZZ026、2023ZR113)。
关键词
宫腔粘连
中医临床决策系统
辨证施治
临床应用
效果
信息化
intrauterine adhesion
TCM clinical decision-making system
syndrome differentiation and treatment
clinical application
effect
informatization
